Use of the Spiritual Development Framework in Conducting Spirituality and Health Research with Adolescents

Purpose:  The purpose of this presentation is to provide researchers and clinicians with an example of the application of the Spiritual Development Framework (SDF) ^{1, 5} in a study regarding spirituality and religiosity (S/R) among adolescents. The current study examined S/R in adolescents with sickle cell disease (SCD). Spirituality is considered a universal phenomenon, but research addressing the S/R needs of adolescents in the context of health and illness is limited. In addition, there is a paucity in the literature addressing methods for conducting research in spirituality, religion, and health with teens. Spirituality and religiosity has been shown to improve coping and correlates with positive health outcomes in research conducted with children and adolescents.^2-4  In order to enhance understanding of spiritual development among adolescents and the role of S/R in their lives, use of the SDF may be valuable to researchers when applied to spirituality and health research with teens. Understanding how S/R impacts health and illness will support researchers in research development and analysis. This knowledge will also assist clinicians in identifying spiritual strengths and appropriate resources adolescents can use to cope with challenges, illness, or other life events. Identifying best practices to evaluate S/R needs of adolescents, will assist clinicians in providing developmentally appropriate holistic care that is essential for adolescents’ quality of care and quality of life.

Methods: A descriptive qualitative design was used for the current study. Sickle Cell Disease Interview Guides were developed using the Spiritual Development Framework (SDF) as a guide. The SDF provides a foundation for conceptualizing the spiritual element of human development.^1,5 The SDF focuses on adolescence and was developed based on data from focus groups conducted with adolescents, young adults, parents, and those working with youth in 13 countries.^1,5 In addition, international experts participated in a method of consensus that guided development of the SDF. In the current study, the SDF was used to frame the study and guide the development of the research questions, the interview guides, the data analysis, and interpretation of the results. Interviews for the current study were audiotaped and transcribed verbatim. Nine adolescents completed two semi-structured interviews (Mage = 16.2 years). Participants were recruited from a pediatric SCD clinic and one support organization. Participant and Parent Demographic Forms were used to collect demographic information. SCD Interview Guides elicited information on beliefs. NVivo 10 was used for analysis. Qualitative data from interview transcripts were categorized and coded. Data were analyzed using a template analysis style and a concurrent process of content analysis. The template was developed using fundamental concepts of the SDF.

Results:  Four major themes emerged to include spirituality as coping mechanisms, shaping of identity, influence of beliefs on health and illness, and expectations of health care providers. The theme spirituality and religiosity as coping mechanisms included six threads to include: interconnecting with God, interconnecting with others, interconnecting with creative arts, scriptural metanarratives, transcendent experiences, and acceptance and finding meaning. The theme expectations for health providers included two threads to include: religiosity is private/personal and sharing spiritual and religious beliefs can be risky.                                                                                                                                  

Conclusion:  Spirituality and religiosity are salient among adolescents. This was particularly evident in adolescents with SCD. Findings from this study identified ways adolescents relied on their S/R to cope with life and specifically their SCD. Use of the SDF may provide a foundation and systematic method for developing and conducting more robust studies with adolescents in the context of spirituality and health.